HIV testing

All posts tagged HIV testing

This evening, for one night only, we are starting the weekend with a special outreach session at The Place. We are there in partnership with the 201 Dance Company who are presenting their latest production ‘If you leave’. It is a beautiful story of a same-sex relationship and will be part of the Resolution 2015 festival. It is raw, cutting-edge hip-hop with a homosexual twist. We will be there with a supply of sexual health leaflets and other goodies, ready to talk about any of the issues raised in the piece and to make referrals to relevant sexual health and wellbeing services. So, what are you waiting for? If you’re in London tonight why not come down, have a chat with GMI’s very own Rob and Tony, and enjoy the show! We’re there from 7-10pm, and full details of the event can be found here.

When you ask people what sort of HIV prevention campaign is effective, by getting people to test and reducing risk taking behaviours, most people say something shocking is needed – like the falling tombstone used in the UK adverts of the 80s below. But, it this really the best approach, and what are the arguments for and against trying to scare people into having safe sex?

The very fact that most of you reading the blog can recall the tombstone advert seems to demonstrate one advantage of such an approach – done properly it can be extremely memorable, and can attract lots of attention, and really get people talking about HIV. In addition, there is evidence that if someone feels they are equipped to make behavioural changes necessary (whether physically or psychologically) then there is some evidence that this type of approach might have a successful impact. However, the flip side is that such individuals are more likely to already be engaging in safer sex and test frequently anyway, and are (in many ways) not the most useful group to target with HIV prevention messages. In addition, crucially, those that are ‘less well-resourced’ to negotiate safer sex may actually ‘feel even worse when confronted with fear-arousing messaging’ and they might result in feelings of anger or defensiveness which can actually result in unsafe sexual behaviour (see a Sigma report on fear and HIV prevention here for more info).

Other potentially serious consequences of fear based approaches is that they can result in othering of people with HIV and actually increase discrimination as the fear of the virus is transferred to those that have HIV. It can also increase anxiety about HIV which research shows is one of the main barriers preventing people from testing. In addition, there is evidence which shows that fear only translates into behavioural change when people are not fearful, and data from the Gay Men’s Sex Survey shows that most gay men are still HIV and view it as a serious illness. In conclusion, while inducing campaigns can make people more scared of HIV there is little evidence that this would encourage people to make behavioural changes necessary to reduce risk, or increase testing, particularly those that might be seen as most at risk groups.

It is likely that for these reasons HIV prevention campaigns have become less shocking in the last couple of decades. The poster above shows a current campaign by HPE in the UK using the tagline ‘It starts with me’ . Similarly, in New York where HIV prevention campaigns have traditionally been fear-arousing (such as the shocking 2011 NYC department of health advert which included a close-up photo of anal cancer, see here), there has been a move away scare based approaches. For example, the latest HIV prevention campaign by the NYC department of health uses the phrase ‘Be HIV sure’. Dr Daskalakis, who is behind the campaign, claims that its aim is to focus more on health and less on disease. This change in city-wide approach is supported by others working in HIV in New York, such as Terri Wilder of ACT-UP . These ‘softer’ approaches seek to increase knowledge and empower people to make informed decisions through positive terminology, rather than scaring people with explicit imagery and negative wording.

What do you think HIV prevention campaigns should look like? Are dramatic images and shocking phrasing effective, or do you think they are counter-productive?

The views in the article are those of the author and do not necessarily represent those of the GMI Partnership. The GMI Partnership provide rapid HIV testing and outreach work across London. For more information please see their website.

On April 6th this year self-testing HIV kits were approved in the UK, following a government amendment to the law, and within the next few months it is likely they will be available to buy over-the-counter for the first time. So, what is a self-testing kit?

A self-testing kit is a do-it-yourself test for HIV which uses saliva or a blood sample to provide an instant result. It is different to a home sampling/screening test where the test is done at home and then sent away for laboratory analysis, normally providing a result within 3-5 days.

Currently self-testing kits are not yet on sale in the UK and no companies have applied for a license to sell self-testing kits within the EU, even though they are now legal here. When they are finally on sale they will carry the CE mark to show they can be used safely.

What are the advantages of self-testing for HIV?

Reaction to self-testing kits has been largely positive, as reflected in this comment by a spokesperson for the Royal Pharmaceutical Society, who said “”HIV self-testing kits may help increase diagnosis by providing more choice for people who have been at risk but are reluctant to get a test in person from existing services.”

Convenience: There is no booking appointments, no waiting times and no going to the clinic so self-testing is a convenient way to do an HIV test.

Privacy: Doing the test from your home is private and anonymous and you don’t need to talk to anyone about doing the test, which might be preferable for some people.

For these reasons it is possible that self-testing will increase the likelihood that those who have never tested/test infrequently know their HIV status and, as a consequence their use could result in a drop in undiagnosed HIV cases and late diagnoses.

Are there any disadvantages?

Cost: Self-testing kits need to be bought and aren’t available for free like home sampling/screening tests.

Support: When testing at a clinic or pop-up testing service you speak to a trained advisor who is able to have a pre-test discussion, answer any questions and signpost to appropriate services.

Misdiagnosis: There is some worry that people who don’t understand the test might misinterpret the result, although there were similar concerns about pregnancy testing and this is now commonplace.

Other ways to test:
Self-testing and home sampling are great additions to current testing options, but are not appropriate/preferable for everyone.

NB – If you have had unprotected sex in the last 72 hours (and there is risk of HIV transmission) it is possible to take Post-exposure prophylaxis (PEP) to reduce the chance of transmission. PEP can be obtained from and sexual health clinic or accident and emergency department.

Hi everyone! We haven’t updated the blog in a few weeks because we have been busy re-launching GMI. That’s right – we are still here and very much active, but there have been some changes to our service. We have just started doing some completely new work meaning we are in more venues, more often than ever before. In fact, we are aiming to be present in every LGBT venue in London at some point over the next few months! We’re looking forward to the new opportunities this brings – especially the chance of working with new venues and reaching more men than has been possible in the past. As a result our work is now split into 2 areas: outreach and HIV testing.

Outreach

GMI is funded by the London Councils to engage in outreach in gay commercial venues across London. We also offer monthly, quarterly, and pop-up testing clinics at bars, clubs, gyms and special events throughout the year. Check out our outreach calendar for a testing venue near you!

HIV Testing

With funding from HIV Prevention England, GMI offers rapid HIV testing at locations across London. In addition to the testing we do at our offices(Vauxhall, Stepney Green and Ladbroke Grove), we offer the following weekly clinics – visit our outreach calendar for the schedule.

We do rapid, fingerprick HIV tests – The result comes through in less than 60 seconds!

Unfortunately our mentoring and counselling programmes have now finished and we no longer offer one-to-one health trainer sessions. For more information on counselling available to men around their sexual health, please visit the NHS choices website, or your local GUM or sexual health clinic, or talk to your GP.

As a result of our new work you are more likely to see us out and about across London. We are available at venues across the city to answer any questions you might have about HIV/STI prevention and testing so don’t be a stranger, come over and say hello!

For more information on the new GMI partnership please see our website.

In the UK over 100,00 people are HIV positive (HIV Aware website). Many of those that are HIV positive are in serodiscordant relationships. This means that they are in a relationship with someone who has a different HIV status, in the case HIV negative. There are many barriers to being in a serodiscordant (or mixed status) relationship, but also many opportunities for growing together and for having a stronger, more fulfilling relationship. In this week’s blog we explore a few of those:

Having sex

One area that can cause anxiety in a serodiscordant relationship is sex. Some people who find out they are HIV positive stop having sex all together, whilst others enjoy a full and happy sex life. One of the main reasons that sex life can be affected is the concern about transmitting HIV. This worry can often be reduced through better knowledge of harm reduction and transmission routes. For example, something as straightforward as knowing that risk of transmission through oral sex is very low, having unprotected anal sex as a bottom is the highest risk, and knowing what PEP is can all help lessen concerns about having sex. Some couples also find that counselling and support groups can help alleviate some of the worries about HIV transmission (see below for support numbers).

Disclosing HIV status

One of the biggest challenges to being in a serodiscordant relationship for the positive partner is disclosing their HIV status to their sexual partner. This is difficult primarily because of worries about the HIV negative partner’s reaction. Some partners are supportive and understanding, but others may be angry and upset, especially if they are worried that they may have become (or at risk of becoming) HIV positive. The reasons to disclose or not are complex and vary from person to person and can be impacted by various overlapping factors such as age, culture, treatment, sexual behaviour, transmission understanding and knowledge. Although awareness that a partner is HIV positive can often be a shock, and in some cases can be difficult to deal with, increased understanding of transmission and treatment, and external support can often make disclosing ones status and moving on after disclosure easier.

Uncertainty

The Plus One report published in 2011 (available to download here) showed that one of the prevalent themes in interviews with those in sero-discordant relationships is uncertainty. Uncertainty and fear about transmitting HIV, uncertainty about becoming HIV positive for the negative partner, uncertainty about consequences on sex life and uncertainty about the longevity of relationships following diagnosis. The main cause of uncertainty was described as the ‘lack of understanding about the nature, prognosis or infectiousness of HIV, or about how the other partner felt about the future of the relationship’ (p 2). The report recommended that one of the ways this can be tackled is through giving tailor-made written information about HIV prognosis and transmission to the partners of people diagnosed with HIV.

Serodiscordant or not?

Obviously, the information above is targeted at men who are knowingly in serodiscrodant relationships. Many individuals are in relationships with someone they think has the same HIV status, but who actually doesn’t. One of the main reasons for this is because of a lack of HIV testing. It is recommended to have an HIV test if you are sexually active about every 3-6 months. See here for information on the free, rapid, pop-up HIV testing we do across London and here for info on the NHS website of the nearest sexual health clinic to you.

For support contact:

Positive East (East London support) – 020 7791 2855

Firspoint (South London support) – 020 7160 0949

THT helpline (National) – 08451221200

GMI provide rapid HIV testing and HIV prevention outreach across London. Please see our calendar to see where we are this week.

Pop-up seems to be the word of the moment. There are pop-up shops, pop-up cafes and even pop-up malls. So, why not pop-up HIV testing? Well, that’s exactly what we thought and that’s one of the reasons why we have a series of pop-up HIV clinics across London on different days of the week. As well as testing at one-off events such as pride and music festivals, we have set venues where we can do fee, rapid, HIV tests. The main fixed pop-up clinics are:

In all venues we have a private confidential space where you can test with a healthrainer, who you can also ask any questions about HIV and STI transmission and risk. The test just involves a finger prick, so there are no big needles, like the ones involved in a full blood test, and you get the result within a couple of minutes, so what’s stopping you? We can meet you at the pop-up testing venues, or we can even take you there if you’d feel more comfortable.

Some of the other advantages of pop-up testing are:

It’s convenient, you don’t even need to go to a clinic.

It’s friendly and does not involve speaking to a doctor or nurse.

It is non-judgemental, free and only takes a couple of minutes.

Our pop-up testing has been a huge success and in the last 6 months we have tested almost 500 gay and bisexual men across London. One of the big advantages of pop-up testing is that we are more likely to test men who are having riskier sex and men who are less likely to test than those that would come along to a sexual health clinic.

For World Aids Day we are going to run a testing afternoon on Saturday 23rd November, 1-6pm, at both of the Ku Bars (Soho and China town). The aim is going to be to get as many men as possible to test and our staff and volunteers will be out in the street around Soho/China town promoting the day, so say hi if you see us and come along if you can make it! There will be more information on the testing day nearer the time so keep your eyes peeled!

A belated thank you to the Joiner’s Arms who supported our HIV prevention work by allowing us to run HIV testing at the venue in co-operation with Positive East the Sunday before last. The event was a great success and we achieved a total of 11 HIV tests while we were there. We would also to thank our GMI volunteers and the Positive East volunteers as well as the staff who came along for the general running of the event and, in particular, for handing out hundreds of flyers in the flower market, the local gay bars and in the area around the Joiners Arms.

The iconic Joiners Arms, Shoreditch

As well as testing and handing out sexual health leaflets we also managed to have sexual health chats with men that were at the Joiners Arms and the surrounding area. This is an integral part of the HIV prevention work we do and enables us to inform men about sexual health risk, testing and HIV/STI transmission as well as answering any questions that the men we work with might have about the sex they are having. Research shows (see here for one study) the importance of one-to-one intervention, such as the GMI sexual health conversations, as an effective way to reduce sexual risk taking and to increase knowledge in areas such as testing and transmission. For example, one study based in 8 US cities showed that gay and bisexual men demonstrated behavioural changes in the year following the completion of a sexual health promotion survey in bars and clubs. In the year following the survey self-reported unprotected anal sex was lower, condom use was higher and the number of condoms taken from dispensers across the cities increased (See here ).

For these reasons our GMI healthrainers are out and about across London in venues such as the Joiners Arms doing testing, sexual health surveys and having sexual health promotion-focused chats with gay and bisexual men. Don’t miss your chance to see us at a venue near you! For a full list of locations we work at and our calendar for the month ahead please see the following link.